ING04/08.qxd 13-03-2008 14:39 Pagina 2 WHY BREAST-FEED?WHEN AND HOW TO BREAST-FEED CORRECTLY IT IS NOT TRUE THAT... Mother and Baby. Practical advice for Breast-Feeding.
ING04/08.qxd 13-03-2008 14:39 Pagina 3 The first months of baby’s life, and in particular the moment of breast-feeding, bring with them intense emotions, but also some small difficulties connected to the practical and psychophysical aspects involved. Chicco Observatory has a constant dialogue with parents to explore their needs and, with the assistance of leading experts, looks into the subject of breast-feeding in all its aspects: “The willingness to give support to parents with practical advice has guided us to help you live this extraordinary experience with peace of mind.” The Chicco Observatory thanks The Paediatricians who helped us write this guide Dr. Emanuela Iacchia Psychologist and Psychotherapist Milan-Bicocca University Teaching member of the Italian Society for Behavioural Cognitive Therapy and Fabiana Toneatto Obstetrician Delivery room coordinator - “S. Pio X” Nursing Home – Milan for psychological and obstetric research All the mothers and fathers who have given their valuable contribution to the preparation of this guide, transmitting their enthusiasm, concerns, suggestions and the strong emotion of being parents
ING04/08.qxd 13-03-2008 14:39 Pagina 4 1 Why breast-feed? The opinion of the World Health Organization 1.1 The composition of maternal milk 1.2 The advantages of maternal breast-feeding for the newly born baby 1.3 The advantages of breast-feeding for the mother 2 When and how to breast-feed correctly 2.1 The woman and breast-feeding Difficulties of the newborn baby The breast during pregnancy The baby rejects the breast Care and Hygiene Breast-feeding premature babies When to start breast-feeding Labiopalatoschisis 2.2 Ways of Breast-feeding 2.4 How to know if the newly born baby is feeding well Position and latch on well of the new born baby to the The baby eats when it feels the need breast 2.5 If the baby does not suck sufficiently The best positions for good breast-feeding Mixed feeding The length of feeding Bottle feeding Before and after feeding Formula milk The diet during breast-feeding 2.6 Breast-feeding and the soother When to stop breast-feeding 2.3 What to do in the case of… Maternal breast-feeding: problems Maternal difficulties There is no maternal milk production Rhagades Flat or retracted nipples Breast congestion Mastitis An abundance of milk or the need to be separated from the baby 3 It is not true that…
ING04/08.qxd 13-03-2008 14:39 Pagina 5 Why Breast-feed? 1 Why Breast-feed? “ Mummy, in your milk there is something more than love “ Breast-feeding is a very important phase in the life of the baby and the mother. For the newborn baby latching on to the breast and sucking is not only a primary, physiological necessity, but, above all, it is a moment to relate to the mother, rich in emotions and tactile, auditory sensations, as well as those of taste and smell. Satisfying this need brings about a deep sense of well-being and tranquility for both. Maternal milk contains all the necessary nutritional substances to satisfy the nutritional and psychological needs of the baby up to the age of 6 months. Breast-feeding is so important that all the leading scientific societies, such as the American Academy of Paediatrics and the Italian Society of Neonatology, both state that breast-feeding is the best source of nutrition for the newborn baby, during the first 6 months of life. The American Academy of Paediatrics, moreover, recommends breast-feeding the baby up to the age of one, if possible. The Psychologist Advises… Baby also finds at the mother’s breast, the love and security necessary for a correct psychophysical development. For her part, the mother becomes aware of the deep bond with her child and of how much her baby depends upon her while breast-feeding. It is a way to care for, comfort and make the baby feel how much she loves it. The mother feels pleasure in being a source of gratification for her child and has a feeling of well-being, which she transmits to her baby. A baby, who senses that its mother is well, grows with peace of mind. The Opinion of the World Health Organization “Breastfeeding is an integral part of the reproductive process; it is an unequalled way of providing ideal food for the healthy growth and development of infants”. (Joint declaration of O.M.S. – UNICEF of Geneva - October 1979). Breastfeeding offers so many important benefits that the World Health Organization advises mothers to breastfeed for at least the first six months of life and to continue producing milk up to the first year and beyond, while gradually introducing complementary foods. 1
ING04/08.qxd 13-03-2008 14:39 Pagina 6 1.1 The Composition of Maternal Milk Maternal milk is the ideal food for the baby. It is complete, and it does not require any supplements, at least during the first months of life. It is the basic food for the baby’s nutrition during the first year because it satisfies its nutritional needs. The nutritional elements present in human milk favour an optimal psychophysical development and, at the same time, carry out an important preventive role in regard to development in adult life: obesity, diabetes, arterial hypertension, and arteriosclerosis1 . It contains appropriate quantities of: Proteins: they are more nutritious, easier to digest, less allergenic and with a stronger anti-infective function than cow’s milk. Sugars: of which 90% is made up of lactose. The absence of saccarose in human milk prevents the baby from getting used to the consumption of food which is excessively sweet and reduces the risk of dental decay. Fats: They are well absorbed and digested by the intestines. Human milk is particularly rich in essential fats, that is to say, those fats that the organism is not able to produce and which must be taken with food. Mineral salts: They are not plentiful, but this is an advantage, as the kidneys of a newborn baby are still not able to eliminate an excess of mineral salts with the urine, whilst at the same time, they keep the amount of water that the organism needs. In this way, the organism of the newborn baby avoids the risk of dehydration. Vitamins: They are sufficient for the baby’s needs, including vitamin D, on condition that the mother’s diet is well balanced. Calcium: It is present to a lower extent than in cow’s milk, but it is better absorbed by the intestines Iron: Only starting from the 6th – 9th month of life, is it necessary to integrate this element into the feeding of the baby (weaning). Sodium: It is present in moderate quantities, which prevent the newborn baby from getting used to a salty taste. It protects the baby against the development of arterial hypertension in the course of time. Water: It completely covers the baby’s needs. Human Milk Is not Always the Same Mother’s milk is such a perfect food that its composition changes according to the phases of growth of the baby, the time of day and the time between breast-feedings. The composition of maternal milk also changes during the course of the same feeding session: at the end of the feeding session, the amount of proteins and fats is greater than at the beginning. 1 -Italian Society of Neonatology (SIN). Advice on breastfeeding healthy full-term babies with an adequate weight. Medico e bambino 2002;21:91-98
ING04/08.qxd 13-03-2008 14:39 Pagina 7 Why Breast-feed? 1.2 The Advantages of Maternal Breast-Feeding for the Newly Born Baby Via maternal milk, the baby does not only receive the nutritional substances necessary for a correct growth, but also substances which defend it against infections. With milk, the baby also satisfies its thirst needs thanks to the high percentage of water present in the milk, as well as its need to be reassured and its contact with the mother, above all, in the first months of life. The Psychologist Advises… The experiences of the child during breast-feeding are very important from the psychological point of view due to the relationship that the baby develops with its mother and then with the surrounding environment. The relationship of affection, in fact, is of prime importance in developing its personal identity and acquiring knowledge of the world. During breast-feeding, an intimate and profound communication between the mother and the baby is born: it grows with secret dialogue, shared looks and intense emotions. Maternal Milk and the Immune System Breast-feeding ensures the development of the immune system of the baby, which is still incomplete. By means of the maternal milk, in particular with the colostrum, the mother passes to the baby antibodies, white blood cells and other substances, such as lisozime and lactoferrin, which have important antibacterial, antiviral and antifungal properties. Maternal milk, moreover, contains other substances that “cement” intestinal cells, which makes them less permeable to toxic substances and infective agents.In point of fact, numerous epidemiological studies have shown that babies who are breast-fed are less sensitive to different types of illnesses, for example, gastroenteritis, diarrhoea, vomiting, otitis, infections of the lower breathing passages (bronchitis and bronchopneumonia), infections of the urinary passages and intolerance to gluten. They are less exposed to allergies, bronchial asthma and eczemas (including nappy rashes) than bottle-fed babies are. Because maternal milk is easy to digest, babies have fewer problems of flatulence and colic. Finally, recent studies have shown that breast-feeding has a protective effect regarding cot death syndrome, diabetes, lymphomas and numerous chronic intestinal illnesses2 . Maternal Milk and Intellectual Development An American study has provided interesting conclusions as to why breast-fed babies show better intellectual development and higher visual skills. This is probably due to the presence of appropriate quantities of long-chain polyunsaturated acid fats, also known as omega-3, in maternal milk. These substances are structural constituents of the membranes of brain cells and the retina and apparently help the transmission of nerve stimuli between the cells of the nervous system, and inside the cells themselves. 2 - American Academy of Pedriatrics. Breastfeeding and use of maternal milk. Pediatrics 2005, 17 (1):105-116 1
ING04/08.qxd 13-03-2008 14:39 Pagina 8 Highly Digestible Food Because the digestive capacity of the baby is very low, maternal milk is the only food that is perfectly tolerated and highly digestible. The baby digests it immediately and assimilates it in approximately two hours, absorbing almost in their entirety proteins, sugars, fats and vitamins. Breast-feeding also helps the intestinal function, reducing or preventing the emergence of constipation. The Obstetrician Advises… Maternal milk is always ready and available at the ideal temperature, and it is very practical for the mother. As it does not need to be prepared, it is free from the risk of contamination of germs or any errors that may occur during the preparation itself, and, therefore, it is safe for the baby.
ING04/08.qxd 13-03-2008 14:39 Pagina 9 Why Breast-feed? 1.3 The Advantages of Breast-Feeding for the Mother There are many advantages of breast-feeding for the mother. • During breast-feeding, the mother’s body produces prolactin, a hormone that, apart from being responsible for the production of milk, lessens the effect of other hormones that affect arterial pressure and mood. The Psychologist Advises… Breast-feeding helps with the relaxation and psychophysical well-being of the mother, which, in turn, increase the bond of love with the baby. In women who breast-feed, in fact, the appearance of post-partum depression is less frequent, because the mother feels she has a more essential role in the growth of her baby. • The immediate contact with the baby (in the first minutes after birth) stimulates the production of another hormone, oxytocin, which accelerates the contraction of the uterus, helping it to return to its normal size and reducing the post-partum loss of blood. • Frequent breast-feeding, as the sole source of food, delays the return of the menstrual cycle, in this way allowing the mother’s body to increase its reserves of iron and avoid developing anaemia. • Breast-feeding as the sole source of food, moreover, inhibits normal ovulation, therefore reducing fertility and thus the risk of another pregnancy. The Obstetrician Advises… It is however advisable to be very careful, especially towards the end of breast-feeding because ovulation could recommence without any obvious signs. • As it requires a greater consumption of energy, breast-feeding allows the mother to consume the fats accumulated during pregnancy – directly accumulated with breast-feeding in mind – and therefore to return more easily to an ideal weight. • Breast-feeding reduces the risk of ovary and breast cancer. An important piece of research published a few years ago in one of the most respected medical journals, “Lancet”, and carried out on about 150.000 women, concluded that breast-feeding reduces by over 65% the risk of illness through this type of cancer3 . • While breastfeeding draws calcium from the mother’s bones, calcium is then redeposited in the women’s skeleton in a more stable form during weaning. This reduces the risk of menopausal osteoporosis and hip fractures in women who have breastfed. • Maternal milk is also economical and available at any time. 1 3 - Collaborative group on Hormonal Factors in Breast Cancer. Lancet 2002;360:187-195
ING04/08.qxd 13-03-2008 14:39 Pagina 10 When and How to Breast-Feed Correctly 2.1 The Woman and Breast-Feeding The Breast in Pregnancy The breast is an organ formed by glandular tissue, made up of lobes responsible for the secretion of milk. It is also made up of support tissues and fatty tissues, which isolate and protect against external impact. Each lobe has an excreting tubule, which flows into larger channels called milk ducts, which, in Breast normal Breast pregnancy During breast-feeding turn, reach the tip of the nipple. The nipple is surrounded by conditions the mammary areola, a circular area which is darker than the skin, with small, irregular protrusions of a glandular character called Montgomery’s tubercles. Already in the first weeks of pregnancy, due to the effects of some hormones, including the estrogens and progesterone, the breast becomes harder and a feeling of tension and heaviness may result. The mammary areola becomes darker and the Montgomery’s tubercles protrude more, as they are ready to secrete a fatty substance, which lubricates and protects the nipple during breast-feeding. Towards the fourth month, the colostrum can begin to secrete from the nipple. This, however, is not an indication of the production of particularly abundant milk. Following the increase in volume, the skin of the breast, which has the important role of containment and support, can easily relax to the extent that stretch marks can form - reddish stripes caused by the laceration of the elastic fibres of the inner layer of the skin called derma. The Obstetrician Advises… Care and Hygiene - In order to breastfeed well, it is important to keep fit and look after your breasts during pregnancy. Wear a bra that supports the breast and adapts to its growth during pregnancy, preferably without underwiring that could put pressure on the ducts. Always wear clean clothes, especially if the nipples secret fluid. Keep your breasts clean and moisturized and toughen the nipples with massages in preparation for breastfeeding. Alternate hot and cold showers or massage gently with a soft glove to stimulate the breasts and the nipples. You can also moisturize the skin using special products. If you have a flat or inverted nipple, pass the tip of the finger from the bottom of the breast up to the nipple and pull it out slightly to encourage the nipple to protrude and make it more supple. 2
ING04/08.qxd 13-03-2008 14:39 Pagina 11 When and How to Breast-Feed Correctly 2.1 The Woman and Breast-Feeding When to Start Breast-Feeding The stimulus to produce milk already occurs during birth, immediately after the exit of the placenta, when the level of estrogens and progesterone, female hormones produced in large quantities during pregnancy, fall suddenly, while the secretion of prolactin, a hormone produced by the pituitary gland (a gland situated at the base of the brain) increases suddenly. This stimulates the production of milk. In the first days after birth, the breasts produce a dense yellowish liquid, called colostrum, which, apart from possessing a very high nutritional value, contains antibodies and other substances to defend the baby from infections for several months after birth. The sucking on the nipple stimulates the production of another hormone by the mother’s pituitary gland, oxytocin, which helps the beginning of the milk volume increase. This is a very important phenomenon, which often creates discomfort. With it appears a pronounced swelling of the breast, together with congestion, a rise in the local temperature and a feeling of tension, which at times can be very strong. Once this phase has passed, in general it lasts 24-48 hours, if the newborn baby has started to suck milk regularly, the disturbing symptoms of the increase in milk volume disappear and the secretion of milk continues without any other particular unpleasant effects. The Obstetrician Advises… To help the flow of milk, it can be useful to apply hot compresses before breast-feeding. Cold compresses after the feeding can, on the other hand, reduce the tension and the swelling of the breast. A good breast- feeding bra can also help to give support to the heavy breast and provide relief. A model without wire, with cups that can be opened completely and which does not constrict the breast is advisable. The shape and size of the breast do not influence the capacity to produce milk. Once the increase in milk volume has occurred, lactation is then maintained thanks to the stimulation of the nipple by the baby and by the empting of the mammary glands during breast-feeding.The production of milk is regulated by the effective needs of the newborn child: the more the baby sucks, the more milk that is produced. It s very important, therefore, not to interfere from the beginning with the sucking rhythms of the newly born child. The mother and the baby must not be separated if at all possible (rooming-in). The newly born baby must be latched on to the breast as soon as it is born and, afterwards, whenever it wants, without restrictions in regards to the time or length of the feeding, both day and night. Factors, which reduce the production of milk Factors that increase milk production Stress Rest Worry Baby’s sucking action Tiredness A good diet with plenty of fluids Pain 2
ING04/08.qxd 13-03-2008 14:39 Pagina 12 2.2 Breast-Feeding Times Most newly born babies that are breast-fed, initially require 8-12 feedings every 24 hours. The timing of the feedings during the course of the day varies from baby to baby and there are no fixed rules. It is better to feed the baby when it wants, every time that it shows signs of being hungry, for example, when it moves its head from side to side, when it sucks its fist or its hand, when it opens its mouth and sticks out its tongue. It is not true that every hungry baby cries, because crying is a late sign of hunger. Rather than the clock, the mother must let herself be guided by her own instinct and experience, which allow her to understand when the baby is hungry. The Obstetrician Advises… After the first few days, when milk production has stabilized, mothers should breastfeed on demand while maintaining intervals of at least two/three hours between one feed and another. This prevents the mother from getting overtired and allows her to manage her social life better. Breast-feeding at fixed times, which ensures the nourishment needs, is however advisable for “lazy” babies, who suck with little energy (for example, those with neonatal icterus). These babies should be woken up at regular intervals and given small and frequent feedings. The Psychologist Advises… Breast-feeding on request establishes a mother-baby relationship based on the trust of the newly born baby who knows that it can rely on its mother in order to satisfy its needs. In the first months of life, sucking does not only mean feeding, but also emotional growth. The baby’s sense of security of being loved, its peace of mind and balance, are certainly influenced by the way in which the baby is fed. How to Hold and Latch on the Baby In order that the baby is best able to suck sufficiently with the minimum of effort, it is important that it is latched on to the breast in the correct manner. Since feeding can require anything from a few minutes to more than half an hour, it is advisable that the mother sits in a quiet place, which allows her to relax, and finds the most comfortable position for her and her baby. To breast-feed correctly, the mother must not lean her chest over the child, but the baby must be brought to the breast. The baby must be kept in a horizontal position: • Facing towards the body of the mother, stomach against tummy; • With the nose in front of the nipple and the knees at the height of the breast; • Supported by one or both of the arms of the mother.
ING04/08.qxd 13-03-2008 14:39 Pagina 13 When and How to Breast-Feed Correctly 2.2 Breast-Feeding Times: Once a comfortable position has been found, the mother needs to bring the baby close to her breast without forcing it, waiting for the baby to open its mouth and stick out its tongue, as if it was yawning. At this point, when the mother offers her breast, the baby latches on and begins sucking. It could be helpful to support the breast not with the fingers in the scissors position, (they risk putting pressure on the milk ducts), but with the hand held like a “C”, with the fingers and palm under the breast and the thumb placed above. Position to“C” The Newborn Baby Is Latched on Correctly When: • Its mouth is open wide and it takes a part of the areola, as well as the nipple; • The part of the areola is more visible above the top lip than under the bottom lip (the milk ducts are squeezed by the movement of the tongue); • The chin and nose of the newly born child touch the breast; • The sucking is initially quicker and then becomes slower and deeper, because the milk initially flows more quickly and is more liquid; • The newborn baby swallows and it does not make any sounds with its tongue, which is a sign that correct sucking does not occur. Correct attack Wrong attack The cheeks are full and not hollow. The Obstetrician Advises… If the newly born baby is correctly latched on to the breast, the mother may feel only a slight discomfort for the first few days. If pain starts, it is necessary to interrupt the feeding, closing the nose of the baby delicately with the fingers and trying to breast-feed again after a short interval. The Best Positions for Good Breast-Feeding No ideal position for breast-feeding the baby exists, because every mother adopts the position that she feels to be the most comfortable. Changing the feeding position, every so often, allows the complete emptying of all the ducts and avoids stimulating the same area of the nipple, which could cause irritation. 2
ING04/08.qxd 13-03-2008 14:39 Pagina 14 The classic position is when the mother is seated with the baby in her arms. The mother is comfortably seated on a low chair with her feet resting on a stool, in such a way that the knees remain raised and the legs can support the baby at a sufficient height to latch on to the breast, without the latter being pulled. It may be In a sitting classic Position on one’s side Rugby position position necessary to position one or more pillows between the legs of the mother and the baby.A mother, however, may prefer a lying down position, on a bed, with the baby at her side. This is often the case when the mother is tired or feels pain, caused, for example, by stitches after a Caesarean birth.A third position is known as the “rugby position”, which is particularly advisable if the mother is subject to mammary congestion, as it helps to empty the inner milk ducts. The baby is held like a rugby ball. The mother supports the baby’s body with the forearm, at the height of her armpit and the baby’s head, with the hand in such a way as to position the baby at the height of her breast. This position is particularly useful in cases where it is difficult to latch the baby on to the breast, after a Caesarean birth, if the baby’s nose is blocked, or when breast-feeding twins. The Length of Feeding There is no fixed rule, because the length of feeding varies from one baby to another. One baby might feel satisfied after ten minutes and another after twenty.The length of the feeding also varies depending on the time of the day and the age of the baby, and is longer in the first three or four days after birth, and it becomes shorter as the feeding progresses. A short breast-feeding session is not necessarily insufficient if the flow of milk is fast and sufficiently abundant. In addition, the flow of milk is greater during the first minutes of feeding and then it slows down. Only when the feeding becomes too long, is it necessary to consult your paediatrician for advice. The Obstetrician Advises… It is generally recommended that the baby should nurse on both breasts every feed.You can start each feed on the side the baby last nursed, letting him suck for approximately 15 minutes before passing him over to the other breast.You should not let baby feed on one side for more than 25-30 minutes, to avoid irritated nipples and sucking without milk intake. Before and After Feeding To avoid the appearance of irritation, or even of rhagades, it is advisable to massage the breast for some minutes before the feeding. It is also advisable to wash the hands to prevent the appearance of an infection caused by a fungus – the Candida Albicans – known as “Candidosis”, which is present when the newborn child has small white spots in the oral cavity.
ING04/08.qxd 13-03-2008 14:39 Pagina 15 When and How to Breast-Feed Correctly 2.2 Breast-Feeding Times This infection can also be passed to the mother during the feeding and the nipples can become red and painful. Even though it is irritating, this is not a serious problem, and it can be easily cured by talking medicine prescribed by the doctor. The breast does not require special hygienic treatment or harsh products, because the secretions of the Montgomery glands ensure the necessary lubrication and protection. The Obstetrician Advises… It is important to always wash your hands well before beginning the feeding. Immediately before feeding, cleanse the breast with lukewarm water and sterile gauze or the practical tissues available on the market, which are specifically intended for breast cleansing during breast-feeding. Ensure they are made from natural products and do not require further rinsing. Also, check that they do not contain tensio-active substances, that can dry the skin, or perfumes, that can change the natural odour of the mother and disturb the baby. After the feeding, wash the breast with lukewarm water without soap, leaving it, whenever possible, to dry naturally in the air. In the case of milk loss, it is advisable to use only breathable nursing pads designed to ensure that the skin is always dry. It is also recommended to periodically spread some drops of your own milk on the nipples and the areola, especially in the case of rhagades. Maternal milk has sterilising, moisturising and healing properties. Before latching on baby to the breast, make sure that its nose is free, and that the baby can breathe properly. If necessary, you may also make use of the specific physiological solutions. The Diet During Breast-Feeding To ensure that the milk secretion continues regularly, and that the milk is well tolerated by the baby, the mother should follow a healthy and balanced diet during the breast-feeding period. The diet should be rich in fibres, liquids, mineral salts and vitamins, together with a good calorie intake (at least 600 more calories) to meet her own nutritional needs and produce a sufficient quantity of milk. • If the mother has to follow a diet without milk or milk products, it is advisable to integrate the diet with calcium. • It is fundamental, moreover, to have a large intake of liquids, above all, in the hot season, for example: water, her- bal teas, and alcohol-free drinks, possibly non-fizzy. • It is better not to eat “Light” foods, as they contain synthetic sugars and tend to ferment: this could cause intesti- nal disturbances to the mother and colic for the newborn baby. Apart from specific cases, for example in the case of allergies or intolerance to certain foods on the part of the parents, or the brothers and sisters of the newborn baby, which have to be communicated to the paediatrician, there are few limitations to the diet of the mother who breast-feeds: 2
ING04/08.qxd 13-03-2008 14:39 Pagina 16 • Coffee, decaffeinated if possible: 1 -2 cups a day; • Tea: detanninated, if possible; • Wine and beer: maximum half a glass of wine or a tin of beer during meals; • Remember that foods like cabbage, artichokes, onions, garlic, asparagus, chocolate, seasoning, spices and seafood give milk a particular flavour. However, this does not mean that you should stop eating these foods during breastfeeding, as the baby will get used to the flavours. Things to eliminate: Smoking must be eliminated or drastically reduced, because nicotine can pass into the milk, causing agitation, diarrhoea, and sickness. Spirits must also be eliminated. The Obstetrician Advises… A breastfeeding mother should have a calm lifestyle and have help with the housework so that she can focus as much as possible on the baby. She also needs to sleep adequately and have the time to breastfeed for as long as is necessary. Psychological traumas, violent emotions and stress are the primary causes for a drop or disappearance of milk secretion. It is also advisable to go on walks to stimulate the circulation, help the intestine function correctly and keep fit. When to Stop Breast-Feeding No precise moment in which to stop breast-feeding exists. Breast-feeding can continue beyond the moment of weaning, integrating the maternal milk with a solid or semi-solid diet, necessary after the 6th month. Following this approach, as suggested by The World Health Organization, breast-feeding can continue also beyond the first year of the child’s life. The Psychologist Advises… Sometimes, it is the mother’s desire that motivates her to continue breast-feeding, since it is a moment of contact and affection with her child. It is advisable that the mother follows her intuition to understand when breast- feeding ceases to be a priority for the baby and when it is a good time to start a mutual independence. It is possible to maintain a good relationship between parents and the child after the first year of age, also by developing different ways to relate, made up of small but important shared experiences.
ING04/08.qxd 13-03-2008 14:39 Pagina 17 Perché allattare al seno Chicco Advises Natural Feeling Antibacterial Breast Pads Antibacterial treatment prevents the proliferation of bacteria in the pad, guaranteeing adequate hygienic protection for the breast. This provides the ideal conditions for preventing irritation or fissures and speeding up healing. New, more transparent materials help the skin breathe, preventing irritation. The inner layer contains ultra-absorbent granules that transform milk into a gel and prevent it from returning to the surface, keeping the skin dry. These ultra-thin pads are extremely soft and gentle on the skin and contained in individual sachets for maximum hygiene. Tests carried out: Microbiological, Chemical, Biological and Transpiration. Clinical studies conducted at the Mangiagalli General Hospital, Milan ANTI-STRESS Light Support Nursing Bra Has double pre-shaped seamless cups in cotton with practical opening. The innovative fabric with bands, with anatomical shaping effect around the chest, offers maximum wearability. With ultra thin shoulder straps, that lighten the pressure on the shoulders. DERMOANTISTRESS Elasticising Breast Serum Baby Protection Formula with Multivitamins and Natural Oils, nourishes and moisturises skin tissues, helping you to prevent the formation of stretch marks during the pregnancy and breast-feeding periods. Active ingredients: Rice Oil, Jojoba Oil, Vitamin E, Vitamin PP, Kigelia and Quillaja Extracts, Olive Oil Extract. Dermatologically and microbiologically tested. Physiological Solution NASONET Physiological Solution. Its cleansing action helps the elimination of excess mucous. Nasonet also has a cleansing action that helps to maintain the natural protective functions of the mucous membranes of the nose. 2 1
ING04/08.qxd 13-03-2008 14:39 Pagina 18 Chicco Advises… Natural Feeling Antibacterial Breast Pads ANTI-STRESS Light Support Nursing Bra DERMOANTISTRESS Elasticising Breast Serum Physiological Solution NASONET Discover the other Chicco products on our website www.chicco.com, and find the most conveniently located store.
ING04/08.qxd 13-03-2008 14:39 Pagina 19 When and How to Breast-Feed Correctly 2.3 What to Do in the Case of… Maternal Breast-Feeding, Problems During breast-feeding, especially during the most delicate early phases, the mother or the child may have different problems of a medical, psychological or social nature. These problems can make breast-feeding difficult or indeed prevent it. Often, some of these problems can be overcome, especially if the mother wishes to breast-feed and has the physical and psychological support of her partner, of the people who are close to her or of the health experts. The practical and specific supports available on the market can also help. In other cases, on the advice of a paediatrician, it may be necessary to change from breast-feeding only to mixed feeding or sometimes, to only formula feeding. Maternal Difficulties There Is No Milk Volume Increase Cases of actual impossibility for the breast to produce milk are extremely rare. It may happen that the milk volume increase does not occur. In this case, and in the case that the production of milk stops or becomes insufficient for the needs of the baby, the paediatrician will advise the mother whether it is necessary to use formula milk. Nipple Rhagades Rhagades often occur, especially in women who have recently started breast-feeding or have started for the first time. Rhagades are small cuts, situated at the base, in the middle and at the tip of the nipple. They often cause blee- ding and are very painful, especially during the sucking. The pain can become acute, to the point of discouraging the mother from latching the baby on to her breast. It is necessary to treat this immediately in order to avoid infection from germs commonly present on the skin and a consequent inflammation of the mammary glands (mastitis). It is possible to prevent rhagades effectively: • Paying particular attention to the correct position of the baby during the feeding. • Cleaning the nipple very thoroughly, before and after the feeding, avoiding the use of soaps or detergents. • Keeping the nipples dry and allowing the free circulation of air around them. • Frequently changing the nursing pads. For treatment, it is advisable to: • Use the specific Idrogel disks • Spread some drops of milk on the nipple, as this has sterilising, moisturising and healing properties. Protect the nipples during feeding with the use of nipple shields. 2
ING04/08.qxd 13-03-2008 14:39 Pagina 20 Flat or retracted Nipples Nipple eversion, which usually occurs when the areola is stimulated, is very rare in flat nipples. It is even rarer when nipples not only fail to become erect but tend to retract when stimulated. These are called retracted nipples. Having flat or retracted nipples does not necessarily mean that you cannot breastfeed, as the baby sucks the whole areola, not just the nipple. However, breastfeeding will be more difficult as your baby will have trouble sucking. To make breastfeeding easier, use nipple correctors that stimulate nipple eversion (only after consulting your gynaecologist or obstetrician and not before the 35th week of pregnancy). Nipple correctors can be used after delivery, just before a feed. Stretching and rotating movements described above also encourage nipple eversion. The baby’s sucking will also help shape the nipple. Nipple shields can also aid breastfeeding in this case. Breast Congestion This involves an important increase in the texture and tension of the breast, together with swelling, redness, pain and a rise in the local temperature following the presence of a residue of milk in the ducts and the mammary glands. In turn, this pre- sence causes problems in the milk secretion cells and a consequent reduction in the production of milk. Breast congestion is important as it can make a woman more vulnerable to the risk of mastitis (a breast infection), resulting also in high tempe- rature. The primary cause of the problem is insufficient suction by the baby, which, as a result, is not sufficient to empty the breast. Breast-feeding on request can prevent this condition as can empting the breast manually or with a breast pump after every feeding. The necessary measures to avoid this are: • Breast-feeding more frequently (beginning with the more swollen breast); • Gently squeezing the breast during feeding, leaning towards the baby to help the opening of the obstructed ducts. These actions "soften" the breast and therefore help the baby with the sucking; • Placing hot-damp compresses locally to help the outflow of milk. Mastitis This is acute inflammation caused by germs that colonize the skin – in particular Staphylococcus Aureus – which multiply in the mammary gland at certain temperatures and humidity conditions and also due to the nutrients in maternal milk. The breast gets very hot and painful, and this can be accompanied by a high temperature and redness. If you think you have mastitis, consult your doctor if the above symptoms persist for more than 6 hours.
ING04/08.qxd 13-03-2008 14:39 Pagina 21 Perché allattare al seno Chicco Advises Sweet Relax Breastfeeding Cushion ion This helps the expectant mother relax during pregnancy by supporting her back and ensuring a comfortable position during sleep. It is also useful for supporting the baby during breastfeeding and giving relief to the mother’s arms, shoulders and back. It also supports the baby as it grows, providing support when he is seated or lying down. The 100% cotton pillowcase can be easily removed and machine-washed. SURE-SAFE NURSING Hydrogel Soothing Pads They help to prevent irritation or nipple lacerations. In case of raghades, they help the nipples to heal. The Idrogel Disks reduce pain, while soothing, refreshing and protecting the nipple and areola. SURE-SAFE NURSING Breast Relief Packs Safe and easy to use, they give immediate relief in case of breast tension due to milk residues or breast congestion. When used cool, they reduce inflammation and alleviate pain. When used as a warm treatment, they stimulate milk flow, making breast-feeding easier. SURE-SAFE NURSING Natural Latex Rubber Nipple Shields In soft natural latex rubber, they protect irritated nipples, allowing breast–feeding even in the case of flat nipples. The special dome shape and ribbed rings of the teat reproduce the natural characteristics of the maternal nipple. The shaped shield allows baby’s tiny nose to come into contact with the mother’s skin. Available in two sizes. 2 1
ING04/08.qxd 13-03-2008 14:39 Pagina 22 Chicco Advises… Sweet Relax Breastfeeding Cushion SURE-SAFE NURSING Hydrogel Soothing Pads SURE-SAFE NURSING Breast Relief Packs SURE-SAFE NURSING Natural Latex Rubber Nipple Shields Discover the other Chicco products on our website www.chicco.com, and find the most conveniently located store.
ING04/08.qxd 13-03-2008 14:39 Pagina 23 When and How to Breast-Feed Correctly 2.3 What to Do in the Case of… Remedies: • take antibiotics prescribed by your doctor • do not stop breastfeeding and continue nursing on demand • have warm showers before each feed • after every feed, gently squeeze milk out of the sore breast, either manually or using a breast pump, to empty the breast completely • apply cold packs after each feed An Abundance of Milk or the Need to Be Separated from the Baby In these cases, the milk can be extracted and stored to be given to the baby when necessary. After use, all the parts of the breast pump that come into contact with the maternal breast and with the milk must be disassembled, washed and rinsed thoroughly. They must be sterilised after every use, at least until the baby has reached five months of age. The Obstetrician Advises… Ask your obstetrician to show you the ways to manually squeeze the milk or make use of a breast pump, which is practical and quick. It is better to have a breast pump that is equipped with a suction intensity adjustment mechanism, which makes the pump more delicate. It is advisable to ensure that the milk flows directly into the specific containers, which can be sterilised and closed hermetically. If it is necessary to store the milk, it is advisable to fill the container with a quantity of milk sufficient for only a single feeding. Close the top well and attach a label with the date of extraction. The milk can be kept at room temperature for approximately 8 hours, or stored in the fridge for up to 72 hours, in the freezer for a maximum of 3 months or in a freezer at - 18°C for a maximum of 6 months. The milk must be thawed at room temperature. Before feeding, it must be heated in a Bain Marie, with a feeding bottle warmer or in a microwave oven. Before feeding the baby, gently shake the container to ensure that the milk has a uniform temperature.The containers that can be used with a ring and teat allow you to feed the baby without further changes of containers. Remember that medication can pass into maternal milk even in small quantities, so it is advisable not to take medicine during breastfeeding. If necessary, seek advice from your doctor. 2
ING04/08.qxd 13-03-2008 14:39 Pagina 24 Difficulties of the Newborn Baby The Baby Rejects the Breast The difficulty that a baby has in latching on to the mother’s breast, does not necessarily express a refusal, but rather the presence of a problem, which must be recognised, met and overcome. More often than not, these involve difficulties that arise during the feeding, for example the baby is in an uncomfortable position, or it finds it difficult to suck correctly because its nose is blocked, or the flow of milk is too abundant or rapid. In addition, following an excessively long interval between one feeding and the next, the baby can be over hungry and not manage to co-ordinate its movements and latch on correctly. If the baby continues to reject the mother’s breast on a number of consecutive occasions, it is advisable that the mother extracts her milk and tries to offer it to the baby in other ways, while patiently trying to solve the problem. In this period, the mother must be careful to meet the needs of her baby in regards to the mother-child contact. It is important that she receives practical and emotional support and help until there is a return to normal breast-feeding. Breast-Feeding Premature Babies A premature baby, especially if born before the 32nd week of pregnancy, has an insufficient development of its sucking, swallowing and breathing functions, which are the basis of the independent capacity for feeding. Such newly born babies are therefore fed through a gastro-nasal probe until they are sufficiently mature to be fed by the mother. These babies can be helped to develop or increase their capacity to suck and swallow with the help of a soother, moving gradually towards independent feeding, with the breast or the feeding bottle. Studies have also shown that non-nutritional sucking reduces the stay in hospital, and improves the sleeping and waking pattern, together with movement in the youngest newborn babies1. The Obstetrician Advises… If your baby is still not able to suck at the breast, you should extract your milk with a breast pump every 2-3 hours, that is, as many times as there would be breast-feeding sessions.You should begin as early as possible, because the colostrum is particularly important for your child. The milk should be stored in specific sterile or sterilisable containers. In hospital, paediatricians feed the baby with milk using a probe or a feeding bottle. When your baby will be able to suck by itself, it is possible that it will not be easy to latch it on to the breast at the beginning. Persist patiently, without getting discouraged. If the baby does not manage to feed at the breast, it is important that you continue to feed it with your milk. 1 -Dealing with nipple pain and/or traumas associated with breastfeeding. Evidence Based Practice Information Sheet for Health Professionals. Best Practice 2003;7:1-4
ING04/08.qxd 13-03-2008 14:40 Pagina 25 Chicco Advises SURE-SAFE NURSING Gentle Adjustable Breast Pump Manual breast pump, ideal for extracting milk occasionally. The specific suction intensity adjustment valve reproduces baby’s natural sucking rhythm. It also ensures maximum gentleness, because it allows you to select the correct suction intensity for the physiology of your breast. The ergonomic handgrip allows you to extract the milk gently and without effort. The Shaped breast cup with its special wavy design and the soft silicone rubber membrane ensures maximum comfort and adherence while optimising suction. SURE-SAFE NURSING Electric Breast Pump Ideal for frequent use, it extracts milk quickly and very easily. It reproduces the same physiological rhythm used by the baby during breast-feeding. It has a dual adjustment system that allows you to choose: - The suction rhythm that reproduces the two sucking phases of the baby – stimulation and extraction. - The suction intensity that is more appropriate for your needs and the physiology of your breast. The shaped breast cup with its soft silicone rubber membrane offers maximum comfort and makes milk extraction even more effective. The exclusive anti-regurgitation system prevents the milk from returning into the suction pump, ensuring hygiene and cleanliness. 2
ING04/08.qxd 13-03-2008 14:40 Pagina 26 Chicco Advises… SURE-SAFE NURSING Gentle Adjustable Breast Pump SURE-SAFE NURSING Electric Breast Pump Discover the other Chicco products on our website www.chicco.com, and find the most conveniently located store.
ING04/08.qxd 13-03-2008 14:40 Pagina 27 When and How to Breast-Feed Correctly 2.3 What to Do in the Case of… Maternal milk is more precious than ever for a premature child. The immune properties of maternal milk, in fact, protect the newly born baby against illnesses to which it is more vulnerable because it is premature. Moreover, this type of milk is easy to digest and does not tire its little body. Feeding the baby with her own milk, also helps the mother to overcome this delicate moment, knowing that she is doing something very important for her child. Labiopalatoschisis What Is It? Labiopalatoschisis is a congenital malformation of the lips and palate that affects one newborn child in every 1000, with various degrees of seriousness. The ability of the baby to feed itself independently can be compromised, according to the degree of seriousness of the malformation, but not made impossible. It is believed that, if the mother has very prominent nipples, the baby will be able to feed itself at the breast, especially if the mother is given support by hospital staff and the people who surround her. These babies, however, tend to get tired easily and, for this reason, the use of a feeding bottle is often adopted. In the case of labioschisis, it is possible to use soft teats with large openings to help the flow of milk. In the event of Labiopalatoschisis, before adopting a palatal plate, it is advisable to use a large teat. However, after the adoption of a palatal plate, a teat of smaller size works perfectly well. After the lip operation, the baby can be fed with a soft, silicone spoon. After the operation to the palate, a cup with a soft spout can be used. For further information, it is possible to contact: Labiopalatoschisis Association – Milan – Via Cernaia , 4 – 02- 6598951 – website www.associazionelps.it. Otherwise, consult the website www.chicco.com in the From 0 Months + Breast-feeding section. 2
ING04/08.qxd 13-03-2008 14:40 Pagina 28 2.4 How to Know if the Newly Born Baby is Feeding Well Knowing if a small baby eats enough and how much it eats when it breast feeds is not always easy. To check whether the feeding is sufficient, it is possible to note clear signs, such as the appearance of the baby, the amount of urine passed in one day and its behaviour between one feeding and another. There is no reason to worry if the baby urinates sufficiently to wet six nappies a day, and its faeces are liquid or semi-liquid, occurring three or more times a day during the first three weeks, and then, they are soft and plentiful at least once every 3-4 days after, and if the baby appears well and happy. It means that the baby is taking an adequate quantity of milk. It is also sufficient to check its growth once a week: if the increase in weight in the first weeks is on average 125 - 200 grams a week, it means that everything is proceeding well . It is important to remember that the growth of a baby, which is breast-fed, is not as fast as that of a baby who is fed with milk or artificially, but it is much more constant. Because it is not possible to compare the two growth patterns, two differentiated tables of development exist for breast-fed babies and those who are fed artificially. Any family paediatrician can supply parents with these tables, which are based on statistical data. Therefore, it is important to know that there are babies who are very healthy even though they are not represented in both charts. Another way of understanding whether the baby is actually taking milk while it is breast- feeding, is to observe the rhythm of sucking, which, during the course of feeding should pass from a more rapid and uniform rhythm to slower suction cycles, when it is often possible to hear the sound of swallowing. The Baby Eats As Much As It Needs The amount of milk that a baby requires varies a lot. It depends principally on how much it weighs, how it is growing and how many months old it is. Not every feeding is the same, and it can also vary a lot in the course of one day. All the same, if the newborn baby is well, it can regulate itself and the mother soon learns to place her trust in the baby. The Obstetrician Advises… To understand if your breast-fed baby is growing well, check its increase in weight on a weekly basis, as well as its feeding patterns, which we recommend you note down, for example, as follows: Date Weight No. of feedings/day Bodily discharges/day 1st week 2nd week 3rd week This information will be very useful also during the regular visits to the paediatrician
ING04/08.qxd 13-03-2008 14:40 Pagina 29 Chicco Advises First WELL-BEING Angled Feeding Bottle The special angled shape of the feeding bottle ensures that the teat is always full of milk, helping to reduce the ingestion of air. Moreover, it allows you to keep the baby in a more natural position during feeding, avoiding any incorrect positions of baby’s neck. It has a Physiological Teat made of pure natural latex rubber, which is very elastic and adjusts to the movements of the baby’s mouth: • The larger base reproduces the shape of the maternal nipple and areola, ensuring the correct position of the baby’s lips and a natural sucking rhythm. • The ribbed rings reproduce the natural characteristics of the maternal nipple. • The anti-hiccup valve allows the air to enter into the feeding bottle, ensuring a regular milk flow and helping to reduce hiccups, regurgitation and colic. WELL-BEING Feeding Bottles 150 ml-250 ml-330 ml The large range of Well-Being feeding bottles allow you to continue feeding the baby with peace of mind. They are made of thermo-resistant glass, which keeps the temperature of the milk for a long time or of unbreakable plastic. They come with a physiological teat in soft natural latex rubber, with specific flows for any need and age. BABY PRECISION Electronic Scales It reads the baby’s weight very accurately, even when it moves. The scales also have a memory that displays the difference between the current reading and the reading already memorised. The luminous digital display allows you to read the weight easily and quickly. 2
ING04/08.qxd 13-03-2008 14:40 Pagina 30 Chicco Advises… First WELL-BEING Angled Feeding Bottle Physiological teat for WELL-BEING Feeding bottles WELL-BEING Feeding Bottles BABY PRECISION Electronic Scales Discover the other Chicco products on our website www.chicco.com, and find the most conveniently located store.
ING04/08.qxd 13-03-2008 14:40 Pagina 31 When and How to Breast-Feed Correctly 2.5 If the Baby Does Not Suck Sufficiently Mixed Feeding In the case that the mother doubts whether the natural breast-feeding is proceeding satisfactorily, the paediatrician can evaluate the situation and advise on the integration of formula milk to be given with a feeding bottle, if necessary. This is known as “mixed feeding”. The baby is fed with formula milk in addition to maternal milk. Mixed feeding therefore allows the mother to maintain the secretion of milk without depriving the baby completely of the benefits of maternal milk. Mixed feeding can be: a) complementary; b) alternated. a) Complementary Breast-Feeding At every feeding, the baby sucks from both breasts, and the quantity of milk that is lacking is substituted by formula milk, which has been prepared for this purpose. Complementary mixed breast-feeding is advised because the frequent stimulus of sucking keeps the secretion of milk active. b) Alternated Breast-Feeding During alternated breast-feeding, one meal is taken only at the breast and the next one only from the feeding bottle. This system is more convenient for the mother, who has more time to spend at work or for herself, but the reduction in sucking on the part of the baby, can bring about the risk of quickly terminating the production of milk. Alternated Breast-Feeding The case in which a mother cannot breast-feed for medical reasons is the exception rather than the rule.Your doctor will advise you and give you information regarding these rare cases. Whilst being aware of the significant advantages in natural breast-feeding, there are situations in which mothers are forced, or prefer, to adopt bottle feeding, either in part or in full. Some mothers find that this type of feeding offers some advantages from a practical point of view: • The mother can always decide when the baby is to be fed; • It is more flexible for the mother and it gives her more freedom; • With the new teats that are more similar to the breast, the baby feeds from the breast or the feeding bottle with the same ease, and without difficulty in changing from one to the other. Moreover, formula milk is made to be as similar as possible to maternal milk. Although it cannot pass antibodies to the baby, it provides all the necessary nutriments and, from a qualitative point of view, is an excellent substitute for the 2
ING04/08.qxd 13-03-2008 14:40 Pagina 32 The Psychologist Advises… The change to artificial feeding must not be seen by the mother as a “defeat” or an inability to care for her baby, because the most important thing is that the baby feels loved and is fed. Moreover, artificial feeding has its advantages, as even the father can feed his baby with a bottle, and the mother can rest. Furthermore, feeding by the father can help to build a father- child relationship, therefore lessening the feelings of jealousy, exclusion and neglect that the new fathers often feel. The feeling of paternity is a process in evolution: a father, who is present psychologically and physically in the first moments of life of the baby, can create balanced relationships of affection and love within the new family. Sterilisation In order to prepare the feeding bottle, it is necessary to carefully follow some advice, which safeguards the well-being and health of the baby. It is necessary to ensure the hygiene of the bottle by cleaning it inside with running water and using the specific bottlebrush. All the feeding bottle accessories must always be sterilised. The newly born baby, in fact, does not have sufficient immune defences against the outside environment, and everything that comes into contact with its mouth can be a means of infection. It is possible to cold sterilise the feeding bottle and its accessories with sterilising liquids or tablets, or hot sterilise them thanks to the disinfecting properties of steam, using electrical equipment or microwave ovens. If powdered milk is used, it is necessary to dilute it in a specific quantity of water, while liquid milk must be poured directly into the sterilised feeding bottle. The bottle is then warmed in Bain Marie, with a feeding bottle warmer or in a microwave oven. Before feeding the milk to the baby, the bottle should be gently shaken to give the milk a uniform temperature. It is recommended to always check that the milk is not too hot, by pouring some drops on the inside of the wrist. The Psychologist Advises… It is important to feed the baby with a feeding bottle in a peaceful and relaxed environment, so that the baby feels your contact and your love in the same way as with breast-feeding. The moment of feeding for a baby represents many sensations, which are different and profound, and transmit feelings of communication, love and tenderness.
ING04/08.qxd 13-03-2008 14:40 Pagina 33 Perché allattare al seno Chicco Advises NATURAL RELAX SOFTLY Gommotto The new Chicco Orthodontic Teat is anatomical and functional because it suits the physiology of the mouth, while stimulating its functions correctly: The hollow space for the tongue distributes the pressure on the palate correctly, helping its correct development. The small reliefs on the tip of the teat, which reproduce the shape of the palate ridges, are a point of reference for the baby, who places the tip of its tongue in the correct position and pushes it upwards with the correct pressure while sucking and swallowing. The ultra thin profile helps the baby to close its mouth correctly, while, in the upper part, the teat is inclined to suit the natural position of the tongue and the correct pressure on the sides of the palate. The teething ring, placed on the narrow end of the teat, gives relief to baby’s gums during the delicate phase when the child loses its milk teeth (only on the product for babies from 4 Months+). The new Chicco shield with soft, convex labial support is similar to the breast, offering to the baby’s lips a comfortable and physiological support. It reduces the stagnation of saliva, which is a source of irritation. The Natural Relax Softly Gommotto is made of soft, latex rubber, a natural material that, due to its characteristics, adjusts to the shape and movements of the baby’s mouth. Approved by SIDO - The Italian Society for Orthodontics and tested by University Clinics. Sterile Gommotto for Premature Babies A small and ultra-light gommotto has been specifically designed for babies weighing very little (only 3.5 grams of weight). It is made of extra-soft natural latex rubber. The heart-shaped shield allows the baby’s tiny nose to breathe correctly. Produced specifically for hospital use. STERILNATURAL Electric Steam Steriliser Compact, easy to carry and silent, it has a practical accessory rack. It allows you to sterilise all of your child’s items in few minutes using the natural sterilizing power of steam. It eliminates bacteria and fungi, keeping the objects sterilised for 3 hours if the lid is not removed. Also available in the version for microwave ovens. NEW STERILSYSTEM Disinfectant for Feeding Bottles and Teats With their high disinfecting power, the Sterilsystem liquid and tablets allow you to disinfect all your child’s objects. 2 1
ING04/08.qxd 13-03-2008 14:40 Pagina 34 Chicco Advises… NATURAL RELAX SOFTLY Gommotto Sterile Gommotto for Premature Babies STERILNATURAL Electric Steam Steriliser NEW STERILSYSTEM Disinfectant for Feeding Bottles and Teats Discover the other Chicco products on our website www.chicco.com, and find the most conveniently located store.
ING04/08.qxd 13-03-2008 14:40 Pagina 35 When and How to Breast-Feed Correctly 2.6 Breast-Feeding and the Soother The Use of the Soother For the baby, sucking is a spontaneous action that gives it pleasurable sensations. It is an answer against fear and the sense of loneliness, as it stimulates the production of substances in the brain, which help relaxation. The soother, therefore, comforts and gives peace of mind to the newly born baby and, thus, to the family environment. The Psychologist Advises… Naturally, the soother must not be a substitute for the intimate mother-child relationship, which is so important for the psychological development of the child. It is advisable to use it when the child clearly shows a strong desire to suck, and avoid using it when it is evident that the child wishes to communicate. The Obstetrician Advises... The use of the soother should be limited, at least in the first phases, to enable good progress to be made with breast-feeding. If there is a reduction in the amount of maternal milk, it is advisable to reduce the use of the soother for a time to encourage the baby to latch on to the breast more frequently. At present, the use of a soother during sleep at night, and during the day, is becoming more widely advised for all babies until the age of 1. A study published in the highly respected scientific journal Paediatrics (the official journal of the American Academy of Paediatrics), has in fact shown that the use of the soother during sleep results in a significant reduction in the risk of SIDS (Sudden Infant Death Syndrome) also known as "cot deaths". Moreover, it has been shown that the use of the soother until the 24th month of life does not interfere with the natural growth of the palate, the teeth or the gums, but in fact, it has a positive influence on the development of the mouth. The sucking of the thumb, which is the usual alternative to the soother, is more dangerous because it exercises more pressure on the teeth and the muscles. It is not advisable to use the soother in the case of frequent otitis or dental malocclusion. It is highly inadvisable to give the soother to the baby after dipping it into sweet substances such as honey or sugar: this could encourage bad feeding habits and result in the early formation of decay in the milk teeth. 2
ING04/08.qxd 13-03-2008 14:40 Pagina 36 It Is Not True That… 3 It Is Not True That… ...If the mother is anaemic or has low levels of haemoglobins, for example caused by an excessive loss of blood during the Caesarean birth, that she cannot breast-feed. This is because the loss of iron during the complete period of feeding is less than the amount lost during the course of a single menstruation. ...Milk loses its nutritional properties with the passing of time. Over time, milk becomes more watery because its composition changes, but not because it loses its nutritional value. ...Short-sightedness is an obstacle for breast-feeding. Breast-feeding is also allowed in the case of severe short sightedness, on condition that there are no injuries to the retina. ...A small breast produces a small quantity of milk, because the production of milk does not depend on the size of the breast. ….Flat or retracted nipples affect breast-feeding negatively, because the baby does not latch on to the nipple but to the areola. ...If the newly born baby does not burp it has not digested the food. A burp is only a sound made by the emission of air, which has collected in the stomach during the feeding, and has nothing to do with digestion. ...Formula milk causes allergies. For the milk to cause allergies, the diet factor must be associated with a hereditary factor. That is to say, that the predisposition to allergies is present in other members of the family (brothers and sisters or parents). 3
ING04/08.qxd 13-03-2008 14:40 Pagina 37 It Is Not True That… 3 It Is Not True That… …Drinking beer increases the production of milk. During breast-feeding, it is advisable to drink more liquids and eat raw vegetables, rich in water. Beer has no particular properties. …A baby who is breast-fed needs to drink water when it is very hot, because maternal milk contains all the water that a newly born baby needs. …Beast-fed babies need a supplement of vitamin D. The newly born baby stores this vitamin during pregnancy and it is sufficient to have regular exposure to the sun during outings in order to obtain all the vitamin D that it needs. …Breast-fed babies need a supplement of iron. Maternal milk contains all the iron that the newly born baby needs, at least during the first 6 months of life. …If a mother has an infection, she must stop breast-feeding. Apart from very few exceptions, the best protection for a newly born baby is to continue to be breast-fed. If the child becomes ill, the duration of the illness is shorter if the mother continues to breast-feed it. …Breast-feeding is inadvisable when vomit or diarrhoea occurs, because, in these situations, maternal milk is the only liquid that a baby needs. 3
ING04/08.qxd 13-03-2008 14:40 Pagina 38 Chicco Natural Latex Rubber. Only for your Baby’s Mouth. Latex Rubber is a natural material that, due to its characteristics, adjusts perfectly to the shape and movements of the baby’s mouth. Natural: Latex Rubber is a natural raw material that is particularly appreciated for its elasticity and softness. The exclusive production cycle designed, developed and implemented in Italy makes the Chicco natural latex rubber, as well as all the other products realised in this material, absolutely unique. Softness: Natural Latex Rubber is ideal because it is so soft that it can be compressed with the slightest pressure. It adjusts to the shape and movements of the baby’s mouth, is soft to the touch and does not irritate baby. Elasticity and Resistance: Natural Latex Rubber is particularly elastic, and lengthens and returns to its original shape very easily, adjusting to the shape of the baby’s mouth. This is a fundamental factor, which allows the natural sucking rhythm of breast-feeding. ( * ) Moreover, its structure makes it highly resistant to the intensity of the baby’s suction and bites, without tearing. Warmth: Natural Latex Rubber is ideal for the baby, because it transmits warmth, naturally and quickly. All the Chicco products derived from natural latex rubber are tested clinically and in vitro. They are free from the principal components that may cause allergic reactions (*ECHOGRAPH AND ELECTROMYOGRAPHY SHOWING DEFORMATIONS CAUSED BY SUCKING: COMPARISON BETWEEN THE MATERNAL NIPPLE IN THE FIRST AND THIRD MONTH OF BREAST-FEEDING AND DIFFERENT ARTIFICIAL TEATS - Paediatric and Neonatal Medicine Section of the Department of Gynaecological, Obstetrical and Neonatal Sciences; Infant Neuropsychiatry Service of the University of Parma, Parma University). Correct Use. Chicco natural latex rubber products can be safely heat sterilised by Any colour or size changes during use do not alter the fundamental boiling. They can also be cold sterilised using specific products available characteristics of the products. It is however recommended to replace the on the market. product in case of evident changes or signs of wear. Any signs of wear are absolutely normal: they simply mean that nature has followed its normal course, to the end. As with all natural things, Chicco natural latex rubber products maintain their characteristics unaltered if you follow some simple instructions: Never expose Never expose the Store in a cool, the product to product to direct dry place direct sunlight sources of heat